888.920.EXEC (3932)
contact@execlaw.com
 

 


APPLICATION TO BECOME AN
EXECUTIVE LAW GROUPTM CLIENT

If you would like to be considered as a possible client of Executive Law Group, please complete this form.  Doing so does not, in any way, obligate you.  The information you provide will simply allow us to check for possible conflicts of interest, while learning a little bit about your concerns and how best to contact you.  We will then get in touch with you for a FREE pre-consultation.  At that time we'll review with you the highlights of your situation and discuss whether Executive Law Group is able to assist you.

Please complete this form by supplying as much information as possible. Then, click on the "Submit" button at the end.

Your Name:
Home Address:
Apt.
City, State  
Zip
Your Title:

Should we send communications or statements to your home address?
Yes No
If you answered No above, please provide another address that we should use.
Other Address:

Please indicate the ways we may contact you.

Yes No Home Phone:
Yes No Home Fax:
Yes No Personal e-mail:

May we contact you at your present employment? Do Not Provide Contact Information You Do Not Want Us To Use.

Yes No Office Phone:
Any Restriction?
Yes No Office Fax:
Any Restriction?
Yes No Office e-mail:
Any Restriction?

We appreciate referrals and like to thank those who have suggested our services.   Please tell us if someone has referred you to us.

Referred by:

I have checked all of the following that describe my circumstances and needs.   I have provided employer names so you can check possible conflicts of interests.

Employer Name(s) (include any division name or d/b/a):
I am an executive in transition.  I have received a severance package, which I would like reviewed.   I want to discuss the circumstances of my separation and/or whether it may be possible to improve my separation package.

I am considering entering new employment.  I want to discuss the terms of my prospective employment and/or have my employment offer, employment agreement or other employment-related documents reviewed before I sign them.

I am in some form of crisis.  I need some advice on my present employment circumstances.  I am facing workplace challenges where it is critical that I make the best possible choices, in light of my legal and/or contractual obligations.  And, I am not necessarily sure what those obligations are.  I need assistance to evaluate my situation, strategize over how to accomplish my objectives, and identify going-forward options.

I am planning my next career move, or I am striking out on my own. I may be subject to non-compete or other restrictive provisions. I do not want to violate any law or agreement on the use of trade secrets or confidential/proprietary information. I'm just not sure what I can or cannot do, or when.

I believe I may have claims against my employer.  I need help to evaluate my situation.  Or, I have been sued by an employee or my former employer. I need to discuss how to defend myself.

I UNDERSTAND THAT COMPLETING AND SUBMITTING THIS APPLICATION DOES NOT MEAN THAT MY REPRESENTATION HAS BEEN ACCEPTED BY EXECUTIVE LAW GROUP.  MY REPRESENTATION HAS ONLY BEEN ACCEPTED IF EXECUTIVE LAW GROUP PROVIDES ME AN ENGAGEMENT LETTER, WHICH I SIGN AND RETURN. 

For more information, please call 1.888.920.EXEC (3932).